Supervisor, Claims Processing

The Supervisor, Claims Processing reviews and adjudicates complex or specialty claims, submitted either via paper or electronically. The Supervisor, Claims Processing works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to solve basic problems; collaborates with management and top professionals/specialists in selection of methods, techniques, and analytical approach.

Responsibilities

The Supervisor, Claims Processing determines whether to return, deny, or pay claims following organizational policies and procedures. Decisions are typically are related to schedule, plans and daily operations. Performs escalated or more complex work of a similar nature, and supervises a group of typically support and technical associates; coordinates and provides day-to-day oversight to associates. Ensures consistency in execution across team. Holds team members accountable for following established policies.

Required Qualifications

High school diploma or equivalent

2 yrs of previous supervisory and /or leadership experience over a minimum of 10 associates

2 years of experience in medical claims in a production quality based environment

Proficiency in Microsoft Office Programs Word, Excel

Previous experience with coordinating and leading projects and tasks

Demonstrated capability with coaching and developing associates formally and informally